AB1029 CLINICAL AND RADIOLOGICAL OUTCOMES AFTER VERTEBROPLASTY AND KYPHOPLASTY FOR OSTEOPOROTIC VERTEBRAL FRACTURES
Authors: A. Ben Tekaya, E. Hannech, M. Bellil, M. Ben Salah
Journal: Annals of the Rheumatic Diseases (2022)

Background Vertebral Fractures are among the most frequent osteoporotic fractures. Pain and spinal deformation cause loss of autonomy and predispose to a higher risk of morbidity and mortality. Vertebroplasty and Kyphoplasty are an efficient therapeutic alternative in the management of these fractures [1,2]. Objectives The aim of our study was to evaluate functional and radiological outcomes of Vertebroplasty and Kyphoplasty for osteoporotic vertebral fractures. Methods It was a retrospective study including patients treated with Vertebroplasty or Kyphoplasty for osteoporotic vertebral fractures with no spinal cord injuries. Clinical, functional, and radiological data were collected. Pain assessment was evaluated by the Visual Analogue Scale (VAS) and the Denis pain scale. Oswestry Disability Index (ODI) was used to evaluate the functional impairment. The measurement of the vertebral height pre and postoperatively was assessed by the Beck’s index on the spine lateral X-ray. Results There were 36 patients: 26 female and 10 male. The mean age was 65 years (41-74). The follow-up period was about 17 months. The thoracolumbar hinge was the most affected region (70%). Twenty two patients were treated by kyphoplasty and 14 by Vertebroplasty. The mean VAS pain improved from 5.28 preoperatively to 2.92 postoperatively (delta VAS pain was 2.36, p&lt;10 -3 ). The improvement in the VAS pain was by 3.42 (p&lt;10 -3 ) in the last follow-up. There was no difference between the two technics regarding the pain improvement (p=0.06). On preoperatively, the mean Denis pain scale was 4. It was 2.19 after kyphoplastyand and 2.27 after Vertebroplasty with no significant difference between the two technics (p=0.6). The mean ODI at the last setback was fourteen: 95 % of patients had minimal to moderate disability, 5% had severe disability. There was no difference between Kyphoplasty and Vertebroplasty regarding the functional impairment (14.87 vs 12.36, p=0.5). Kyphosis on the level of the fractured vertebra improved from 16.8° preoperatively to 9.5° postoperatively with a significantly mean reduction of 7.3° (p&lt;10 -3 ). Regional kyphosis improved from 12.1° to 7.4° with a significantly mean reduction of 4.3° (p&lt;10 -3 ). Beck’s index went up from 0.66 to 0.8 post-operatively (p&lt;0.05). The improvement of kyphosis on the level of the fractured vertebra (angulair gain) was more important for the group treated with Kyphoplasty (8.45° vs 5.5, p=0.01). A significant association was found between the Beck’s index losses with the ODI at the last setback (p=0.02). Complications were cement leakage in five patients without clinical symptoms. We had noted one anterior vascular leak without any clinical implication. Surgical site infection was noted in one case and was managed by medical treatment without any general complication. Conclusion Our study showed that Vertebroplasty and kyphoplasty were both effectively for the pain reduction and for restoration of autonomy in osteoporotic patients. They also allowed an improvement of the kyphosis necessary for an appropriate spinal static’s. References [1]Buchbinder R, Johnston RV, Rischin KJ, Homik J, Jones CA, Golmohammadi K, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2018;6;11(11):CD006349. [2]Chandra RV, Maingard J, Asadi H, Slater LA, MazwiTL, Marcia S, et al.Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? AJNR Am J Neuroradiol. 2018;39(5):798-806. Disclosure of Interests None declared